Salem, NY · Washington County
Application to Local Registrar for Copy of Birth Record
This application lets a person request a copy of a birth record from a local registrar by providing birth, applicant, and identification information.
What this form is
Use this application to request a copy of a birth record from a local registrar. It asks for the subject’s name, date and place of birth, parents’ names, number of copies, and the purpose for the request. The applicant also provides their relationship to the person, contact and address details, signature, and acceptable identification; the form says not to issue a copy unless identification is presented.
Who needs it
A person seeking a copy of a birth record can use this application and must present one of the identification types listed on the form.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This application is signed without a notary; the applicant signs it, and the form lists acceptable identification that must be presented.
How to submit this form
- 1
Download The Application
Download the birth record copy application PDF.
- 2
Complete The Application
Enter the birth, applicant, relationship, contact, address, copy-request, and purpose information, then sign.
- 3
Gather Identification
Prepare one identification type listed on the form; it says a copy should not be issued unless identification is presented.
- 4
Submit To The City
Submit the application to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- Do I need a notary for the birth record copy application?
- No. This application is signed without a notary. The applicant signs it, and the form lists acceptable identification that must be presented.
- How do I submit the birth record copy application?
- Submit it to the city department named on the form; check the city website for current contact details.
- What information does the application ask for?
- It asks for the birth subject’s name, date and place of birth, parents’ names, number of copies, purpose, applicant details, relationship, address, and signature.
- What identification does the form accept?
- The form lists a driver’s or non-driver’s license, passport, naturalization papers, military ID, employer photo ID, two utility bills, or a police report of lost or stolen ID.
Need something notarized?
This Application to Local Registrar for Copy of Birth Record doesn’t need a notary — but if you have another Salem form that does, a commissioned online notary can help.